BUBBLES: Real Time Home Care Scheduling tool limiting (COVID-19) Infection Chains

随着更多的老年患者和那些有潜在健康状况的人呆在家里以降低接触新冠肺炎的风险，预计家庭保健和家庭护理的需求将会增加。减少与他人的接触仍然是将接触新冠肺炎的风险和感染后果降至最低的最可靠保障。我们的解决方案旨在改进现有技术，并添加允许更安全(安全气泡)和灵活性(实时分配)的新功能。众所周知，家庭医疗保健计划和路线问题很难解决。它们包括将护理员分配给住院医生，以便在预定的时间范围内执行需要特定技能的任务。它们本质上是多时段的，规模非常大，并且表现出一些非常独特的特征，例如区域分配限制、遵守技能水平和其他服务资格、硬或软同步和优先级限制、多个起止地点(例如，从医疗中心开始并在轮班结束时回家)、针对内部和签约员工的不同规则和目标、多种交通方式、多个服务时间窗口、截止日期、用于外包、报销或加班的复杂成本函数、服务时间规定(例如，最大值班时间和休息要求)、每天多个班次，考虑到新冠肺炎疫情带来的挑战，我们的解决方案将降低与多名护理接触者相关的感染风险，提高工作人员的效率，并优化路线以最大限度地减少旅行时间和距离(从而降低环境负担)。这与英国政府和英国国民健康保险制度关于家庭保健的建议是一致的，后者提倡根据患者暴露于病毒的风险将患者分成不同的队列。此外，它还建议将工作人员分成不同的小组，每个小组处理特定的患者群，并考虑与病毒相关的工作人员风险。最后，拟议的解决方案认为可能存在意外变化，扰乱了既定的服务计划。使用我们最先进的员工排班技术，我们的解决方案能够实时重新调整排班。总而言之，该工具将带来以下好处：1.安全气泡-通过限制受控制的员工和患者群体的暴露来降低感染风险。2.通过形成包含的“护理气泡”，以最大限度地减少潜在感染链的大小来分配护理人员。更高的灵活性和适应性-我们的解决方案允许有效的实时调度，以a)最大限度地减少重新调度所需的总时间(通常是手动重新调度)，以及b)缓解导致延迟或低质量服务的意外事件导致的效率低下。提高系统的容量--最先进的优化技术，以提高家庭护理团队的调度效率，提高满意度和支持更多患者的能力。更智能的员工分布--明确将员工技能和偏好与患者需求相匹配，确保员工将联系时间集中在最需要其技能的地方(包括适当的远程联系)。环境效益-减少不必要的(远程会诊就够了)和低效汽车旅行的排放，并减少患者去医疗服务机构的需要。

Home healthcare and home care are expected to see increased demand, as more elderly patients and those with underlying health conditions stay home to lessen their risk of exposure to COVID-19\. Cutting down on contact with others remains the most assured safeguard for minimising risk of exposure to COVID-19 and the consequences of infection. Our solution aims to improve existing technology as well as adding novel features allowing for more safety (safe bubbles) and flexibility (real-time allocation).Home health care scheduling and routing problems are notoriously hard to solve. They involve the assignment of caregivers to residencies to perform tasks that require specific skills within a predefined time frame. They are multi-period in nature, very large-scale, and they exhibit some very unique features, such as regional assignment restrictions, compliance with skill levels and other service qualifications, hard or soft synchronisation and priority constraints, multiple start and end locations (e.g., start from medical centre and return home at the end of the shift), different rules and targets for in-house and contracting employees, multiple transportation modes, multiple service time windows, deadlines, complex cost functions for outsourcing, reimbursement or overtime, hours of service regulations (e.g., max duty times and break requirements) multiple shifts per day, and other operational realities.Taking into account the challenges resulting from the COVID-19 pandemic, our solution will reduce infection risks associated with multiple care contacts, improve efficiency of staff, and optimise routes to minimize travel time and distance (thus lowering the environmental burden). This is in line with advice by the UK Government and NHS England on home health care which promotes segmenting patients into cohorts based on their risk of exposure to the virus. In addition it recommends segmenting staff into groups each dealing with a specific patient cohort and accounting for staff risks relating to the virus.Lastly, the proposed solution considers that there may be unexpected changes that disrupt the established service plan. Using our state-of-the-art staff scheduling technologies our solution is able to readjust the schedules in real-time.In summary, the tool will deliver the following benefits:1. Safe Bubbles - Reduced infection risk by restricting exposure due to contained staff and patient groups. allocate care workers in such a way that minimizes the size of potential infection chains, by forming contained "care bubbles".2. Increased flexibility and adaptability- Our solution allows for effective real-time scheduling to a) minimize the total required time of (often manual) rescheduling, and b) relieve inefficiency caused by unexpected events leading to delayed or low-quality service.3. Elevated capacity in the system -- State-of-the art optimisation to improve scheduling efficiencies within home care teams, increasing satisfaction and capacity for more patients to be supported.4. Smarter staff distribution -- Explicitly matching staff skills and preferences to patient need, ensuring staff focus contact time where their skills are needed most (including remote contacts where appropriate).5. Environmental benefits - Lowering emissions from both unnecessary (where remote consultation can suffice) and inefficient car journeys, and reducing the need for patients to go to health services.